Improving Fertility in Men with Poor Sperm Count | UCLA Urology
Erectile Dysfunction, Fertility, and Men's Health
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I received an interesting packet of information from Dr. David Meldrum, a leading reproductive endocrinologist who has taken an interest in male erectile dysfunction (ED). We both noted that since requests for Viagra prescriptions are common, we may want to consider that erectile dysfunction has significantly greater ramifications than difficulty in the sperm collection rooms.
Recent studies have suggested that as men age, testosterone levels will often drop to very low levels. In fact, about 25-30% of men in their fifties may have low levels. If erectile dysfunction is the only concern, then after evaluation, hormone replacement can be very rewarding. But, if fertility is a concern, the addition of testosterone can further lower a sperm count which may already be lower than normal. I have started to measure testosterone levels in men who object or complain about providing a sperm sample and despite reports of not having problems with ED, many of these men have low testosterone levels.
What is so interesting is that we are learning that ED is strongly linked to cardiovascular disease. Men with ED demonstrate increased calcium in the blood vessels of the heart at a younger age. Insulin and nitric oxide are important in both conditions. Men with ED are more likely to have a decreased HDL [good cholesterol] /total cholesterol ratio, putting them at greater risk for heart disease. Some authors have suggested that men with ED are cardiac patients until proven otherwise, and that men with increase cardiac risk factors will soon demonstrate ED if they have not already done so.
Nitric Oxide (NO) is a potent blood vessel dilator and as such is the prime factor in allowing extra blood to pool in the penis resulting in an erection. It is also responsible for dilating the coronary blood vessels and increased blood flow to the heart when needed. NO produces other factors which prevent platelet stickiness and the formation of atherosclerosis plague formation on blood vessel walls. While the use of Viagra may restore function, it does not address the underlying cardiovascular risk that often goes along with ED.
Things that increase NO will likely improve erectile function and will be cardioprotective. Testosterone replacement is beneficial for men who are not trying to produce a pregnancy, but there are other factors to consider. Exercise, antioxidants, folic acid [25% of us need excess folic acid due to dietary deficiencies and genetic differences] omega 3 fatty acid supplementation, calcium and L-arginine. Things to avoid include a high-fat diet, trans fats, obesity, sugar, and alcohol.
For more information from Dr. Meldrum about erectile dysfunction and the associated health risks, please visit www.erectile-function.com.
Video: ED | Can Diabetes Cause Erectile Dysfunction? | StreamingWell.com
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